Geriatric problems awareness among adults in Rawalpindi

Objective: To assess the knowledge, attitude and practice [KAP] regarding elderly age health problems among adults of Rawalpindi

Study Design: Descriptive cross sectional study

Place and Duration of Study: Airport Housing Society Rawalpindi from July 2011 to Nov 2011

Material and Methods: A total of 200 households of age 50-59 years were included in the study by convenient sampling technique [115 males and 85 females]. Adult population of the age 50-59 years with physical and mental disabilities were excluded from the study. Data collected after taking informed consent was analyzed by SPSS 17

Results: Mean age of respondents was 54.78 +/- 3.41 years. Knowledge regarding age limit of senior citizens was 140 [70%]. A total of 174 [87%] knew about increased incidence of fall with increasing age but only 53 [26.5%] did any practical change. About 152 [76%] considered that prior knowledge about geriatric age problems can help plan for old age; efforts to get information about elderly age problems were reported by 170 [85%]. There was a significant association between level of knowledge and efforts to stay healthy [p<.001]. The difference between level of knowledge of males and females was significant [p=.007]

Conclusion: Prior knowledge among residents of the society was found to be a more preferred option to give people information about optimal aging, but this should be started at a much earlier time by facilitating information, to restore physical health to have a healthy and functional elderly individual in the society

Antenatal screening for hepatitis B and C virus infection in pregnant women in a tertiary care hospital of Rawalpindi

To determine the frequency of Hepatitis B and C virus infection in pregnant women and to assess whether it is more common in multigravida as compared to primigravida. A Descriptive Cross Sectional study carried out in the out patient department of Gynaecology and Obstetrics department of Military Hospital, Rawalpindi from August to October 2010. An open and close-ended questionnaire was self designed for this purpose. Data relating to medical, surgical, gynaecological and obstetric history, with particular references to hospital admissions and intravenous interventions was collected through convenience sampling. One hundred and forty pregnant women were questioned. The age of patients varied from 21 to 45 years [mean 28.66 years]. Out of 140 females, 44 [31.4%] females were primigravidas while 96 [68.6%] were multigravidas. Eight [5.7%] females were found positive for HBsAg and 18 [12.8%] were found positive for HCV antibodies by third generation ELISA. It was observed that 0% primigravida and 8.3% cases of multigravida were HBsAg positive cases [p = 0.049]. Frequency of HCV was 4.5% in primigravidas and 16.7% in multigravidas [p = 0.047].Various risk factors like, history of blood transfusion 27.1%, and IV injection 91.4%, were identified. The hepatitis B vaccination rate was only 24.3%. The frequency of Hepatitis B and C infection was 5.7% and 12.8% respectively in pregnant females as compared to the general population. The multigravidas were at a higher risk of HBV and HCV exposure than primigravida

Frequency of contraceptive practice amongst doctors of Pakistan Armed Forces

This study was undertaken on the exponents of motivation and implementation of family planning measures in Armed Forces i.e., doctors, with emphasis on finding their contraceptive prevalence rate. Cross-sectional prospective study. Armed Forces Postgraduate Institute Rawalpindi from March 2003 to June 2004. A comprehensively structured open and closed ended questionnaire was mailed to selected married medical officers of Pakistan Army, Air Force and Navy. Based on their responses the data was prepared, analysed and interpreted. Seventy seven percent of military doctors were practising some contraceptive method at the time of study. Most of the doctors were using condoms for contraception. Sixteen percentage of all respondents have never used any contraceptive in their life. More than 70% believe that the religion of Islam is not a barrier in family planning. Most of doctors were not satisfied with the performance of family planning centres functioning in the Army. There is a dire need to improve the female literacy, awareness about contraceptive methods and their accessibility among military masses of Pakistan

Pattern of toy bomb injuries in Azad Jammu and Kashmir [a hospital based study]

An observational, hospital based study was conducted at CMH, Muzaffarabad to see the pattern of Toy Bomb blast injuries in a period from 1st Jan 2002 to 31st Dec 2003. On an incidence of Toy Bomb Blast injuries, patients reporting to a hospital in Azad Jammu and Kashmir [AJandK] were the core study material for this article. To study the pattern of injuries and their consequences in the studied population. Patients reporting to the hospital with history of toy bomb blast injuries were examined evaluated and followed up. Documents of patient with similar injuries in past treated in the hospital were also included in the study. A checklist guided the follow up of the patients from the incidence that triggered the study. The patients were scrutinized/evaluated according to Advanced Trauma Life Support [ATLS] system of trauma care. Altogether 48 patients record was checked. The age ranged from 1 - 63 years [majority of the patients [80%] were male below 13 years of age], 38 [79%] cases sustained major trauma with multiple injuries of head/neck, maxillofacial, chest, Abdomen and all four limbs. Twenty-four cases [50%] had permanent disabilities. Mortality rate was 20%. Wound infection was very high [60%]. The major complications were depending upon the organ involved/injured. This study points to the need for further studies of this unique method of causation of injuries [toy bomb blast injuries], the pattern they evoke and possible handling of such eventualities. It is desired that at one end the community must be informed and educated about the type, shape, injuries and prevention of the toy bomb casualties and on the other end quick evacuation and proper management of cases be ensured

Estimation of ionized calcium, total calcium and albumin corrected calcium for the diagnosis of hypercalcaemia of malignancy

To measure levels of ionized calcium, total calcium and albumin corrected calcium in patients with different malignant disorders for the diagnosis of hypercalcaemia of malignancy. A case control comparative study. The study was carried out in the Department of Pathology, Army Medical College Rawalpindi, Armed Forces Institute of Pathology and Department of Oncology CMH, Rawalpindi from March 2003 to December 2003. Ninetyseven patients of various malignant disorders, admitted in the Department of Oncology, CMH, Rawalpindi, and 39 age and gender-matched disease-free persons [as control] were included in the study. Blood ionized calcium [Ca++], pH, sodium [Na+] and potassium [K+] were analysed by Ion selective electrode [ISE] on Easylyte[R] auto analyser. Other related parameters were measured by colourimetric methods. Blood Ca++ levels in patients suffering from malignant disorders were found significantly high [mean +/- SD: 1.30+017 mmol/L] as compared to control subjects [mean +/- SD: 1.23+0.03 mmol/L] [p<0.001]. The number of patients with hypercalcaemia of malignancy detected by Ca++ estimation was significantly higher [38%] as compared to total calcium [8.4%] and albumin corrected calcium ACC [10.6%] [p<0.001]. There was no statistically significant difference in other parameters e.g. phosphate, urea, creatinine, pH, Na+ and K+ levels in study subjects and controls. Detection of hypercalcaemia can be markedly improved if ionized calcium estimation is used in patients with malignant disorders

Hospital waste management in a tertiary care army hospital

This direct observational descriptive study was carried out in a tertiary care army hospital from 5th December 2003 to 19th December 2003 to assess its prevailing practices of health care waste management and to estimate hospital waste generated per bed per day. Presently the waste is being segregated and collected in different colour coded receptacles only at the nursing stations and carried in open unhygienic trolleys. The sanitary workers were not using protective devices while handling waste in the hospital. The waste generation was calculated by placing coloured receptacles in selected zones and constant observation for seven days each as mentioned above. Results showed that total waste generation was about 3.434 kg/bed/day [out of which 0.309 kg was infectious, 0.103 kg sharps and 3.022 kg non- infectious] and that final disposal of infectious and non-infectious waste was getting mixed-up while loading in the municipality carriage system. The awareness of sanitary workers regarding colour coding was fair but not up to the mark and they were also unaware of potential hazards of health care waste while handling it. Eighty one percent of sanitary workers were vaccinated against tetanus and typhoid but none of the 86 workers were vaccinated against Hepatitis B. Two single chambered, brick made, gas fired so called [incinerators] with enormously low temperature are being used for burning which are emitting smoke and obnoxious gases directly into the atmosphere, affecting the health of the people and environment. Liquid waste is thrown down the municipal sewerage system without any prior treatment, which is adding up to the water pollution. The study concluded that although some basic steps have been taken towards the effective waste management but still there is a long way to go. Several recommendations have been made to stream line the waste segregation, collection, transportation and final disposal along with the improvement in the awareness of sanitary workers about the potential hazards of health care waste and to get 100% vaccination against tetanus, typhoid and hepatitis B. In the end it is also recommended that national guidelines on hospital waste management must be practically implemented without any further delay

Antibiotic resistance in campylobacter jejuni in Rawalpindi and Islamabad. A preliminary study

To determine the antimicrobial resistance in Campylobacter jejuni isolated from stools of children suffering from diarrhoea/dysentery in our setup against the antimicrobials commonly used as empirical therapy. Study: A prospective cross sectional descriptive study. Place and duration of study: Department of Microbiology, Army Medical College and Military Hospital, Rawalpindi from 29 August to 29 November 2002. Patients and methods: The study was carried out on eighteen isolates recovered from one hundred stool samples of children up to the age of twelve years admitted with diarrhoea/dysentery in Military hospital, Rawalpindi. The samples were collected in clean polypropylene containers containing Cary Blair medium. These were transported to the Microbiology Department, Army Medical College, Rawalpindi within 1-2 hours. The samples were inoculated on Modified Preston [Oxoid] and Karmali media [Oxoid] beside other routine stool culture media. The cultures were incubated at 42oC under microaerophilic conditions. The growth after 48 hours was provisionally identified by colonial morphology, oxidase test, Gram staining and motility. The organisms were identified to species level by hippurate hydrolysis, urease test, nitrate reduction, catalase test, H2S production, resistance to cephalothin and sensitivity to nalidixic acid. Sensitivity testing was carried by Modified Kirby Bauer disc diffusion technique on lysed horse Blood Agar against ampicillin [10 ug], erythromycin [15ug], tetracycline [10ug], chloramphenicol [30ug], trimethoprim/ sulphamethoxazole [1.25ug/23.75ug], nalidixic acid [30ug] and ciprofloxacin [5ug]. One isolate [7.14%] was resistant to ciprofloxacin, three [16.66%] to chloramphenicol and four [22.22%] to nalidixic acid, five [27.77%] to erythromycin, seven [38.88%] to tetracycline, sixteen [88.88%] to trimethoprim/sulphamethoxazole and ampicillin respectively. The susceptibility pattern reflects variable susceptibility with maximum resistance to ampicillin and trimethoprim/sulphamethoxazole. Four isolates were resistant to nalidixic acid

Trends and pattern of tobacco consumption in rural women of Pakistan

A cross sectional study of the trends and pattern of tobacco consumption in rural women of selected villages of Pakistan was conducted to know the existing situation. Total 13 villages were selected according to the proportion of population of each province and accordingly six, four, two and one district from Punjab, Sindh, NWFP, and Baluchistan were selected respectively through simple random sampling. From each village 100 women of age 15 years and above were interviewed at random. Out of 1300 women, 468 [36%] were found tobacco users. Majority of tobacco users [30.34%] were smokers of Hubble bubble. Tobacco smoking/Chewing was started at a mean age of 23.19 +/- 10.77 years. The mean age for current tobacco consumption was 39.50 +/- 14.68.A high tobacco consumption rate was observed in illiterate, divorced/widow and women farmers. Hubble bubble smoking in Punjab, Naswar taking in NWFP and Balochistan and Biri smoking in Sindh is common most form of tobacco consumption